by Kristen Ishihara and Chris Parker with Ishihara & Parker Law Firm PLLC

How to Make Your Spouse Eligible for Medicaid Without Losing Everything

If you’re married and your spouse needs Medicaid for long-term care, you might be wondering, “Do I have to spend all our money first?” The short answer? No! While Medicaid does have strict asset and income rules, there are ways to protect your savings and ensure your spouse gets the care they need.

Let’s break it down in simple terms.

The Medicaid Asset Limit for Married Couples

Medicaid allows your spouse to qualify for benefits once your countable assets are below a certain limit. But not everything counts! Things like your home, a car, and some retirement accounts might be exempt.

Example:

Let’s say on January 1st, your combined countable assets total $200,000. Under Medicaid’s rules, you can keep half of that—$100,000—while the rest needs to be “spent down” to qualify.

Now, Medicaid’s expectation is that you’ll spend that $100,000 on care costs until you reach the eligibility limit. But here’s where planning comes in—there are legal strategies to help you keep as much of that money as possible while still qualifying. This is why getting professional advice is so important.

Minimum and Maximum Asset Limits

Medicaid sets both minimum and maximum limits on how much you can keep.

• Minimum (2024): $3,828
• Maximum (2024): $154,140

If your assets are below the minimum, your spouse qualifies for Medicaid immediately. But if your countable assets are above the maximum, you’ll need to spend down to the $154,140 limit instead of just half.

It’s an individualized calculation, which is why it’s important to know where you stand before making any financial moves.

What Happens After Your Spouse Qualifies?

Getting your spouse eligible is just step one. The next crucial step is protecting your remaining assets so they don’t end up going back to Medicaid later.

Here’s the deal:

• After qualifying, all countable assets should be transferred to the spouse at home.
• Then, update your estate plan to ensure those assets don’t end up back with the spouse in the facility if something happens to you first.
• This often means using trusts, beneficiary updates, and Lady Bird deeds to keep assets out of probate (because Medicaid can try to recover costs from your estate if assets go through probate).

This follow-up planning step is something that often gets overlooked but is critical to making sure you keep what’s yours.

What About Medicaid for Home Care?

If your spouse needs care but wants to stay at home, Medicaid has a program called STAR+PLUS Waiver that can provide in-home assistance. However, there’s a waiting list, and the rules can be a little tricky. If this is something you’re considering, definitely talk to an expert before making any financial changes.

The Bottom Line

If your spouse needs long-term care, don’t panic—and definitely don’t start spending all your money without a plan. Medicaid has rules that allow you to protect your home, assets, and income while still getting your spouse the care they need.

If you need help figuring out what applies to your situation, we’re here to guide you. Reach out for an individualized review, and we’ll help you navigate this process so you can breathe easy knowing your spouse is taken care of and your finances are secure.

Need Help?

We work with couples every day to ensure they qualify for Medicaid while keeping as much of their hard-earned savings as possible. If you need guidance, schedule an appointment with us—we’ll send you a checklist of what documents you need and walk you through the process step by step.

No one should have to go broke to get care for their loved one, and with the right strategy, you won’t have to. Let’s make a plan together!

‍